Chronic kidney disease (CKD) affects 15–20% of adults globally and causes various complications, one of the most important being cardiovascular disease (CVD). CKD has been associated with many CVD subtypes, especially severe ones like heart failure, independent of potential confounders such as diabetes and hypertension. There is no consensus in major clinical guidelines as to how to incorporate the two key measures of CKD (glomerular filtration rate and albuminuria) for CVD risk prediction. This is a critical missed opportunity to appropriately refine predicted risk and personalize prevention therapies according to CKD status, particularly since these measures are often already evaluated in clinical care.In this review, we provide an overview of CKD definition and staging, the subtypes of CVD most associated with CKD, major pathophysiological mechanisms, and the current state of CKD as a predictor of CVD in major clinical guidelines. We will introduce the novel concept of a “CKD Add-on”, which allows the incorporation of CKD measures in existing risk prediction models, and the implications of taking into account CKD in the management of CVD risk.

慢性肾病 (CKD) 影响全球 15-20% 的成年人并导致各种并发症，其中最重要的一种是心血管疾病 (CVD)。CKD 与许多 CVD 亚型有关，尤其是严重的亚型，如心力衰竭，与糖尿病和高血压等潜在混杂因素无关。关于如何将 CKD 的两个关键指标（肾小球滤过率和蛋白尿）用于 CVD 风险预测，主要临床指南尚未达成共识。这是根据 CKD 状态适当改进预测风险和个性化预防治疗的重要机会，特别是因为这些措施通常已经在临床护理中进行了评估。与CKD最相关，主要病理生理机制，以及主要临床指南中 CKD 作为 CVD 预测因子的当前状态。我们将介绍“CKD 附加组件”的新概念，它允许将 CKD 措施纳入现有的风险预测模型，以及在 CVD 风险管理中考虑 CKD 的影响。